MONTGOMERY — Alabama's Certificate of Need process is a "waste of health care resources," according to one state lawmaker.

In Alabama, any hospital or medical clinic that wants to open, add beds or relocate must first be approved by the Certificate of Need Board. A bill was introduced in 2022 to eliminate the CON review program, but the bill didn't pass. The governor appoints members to the CON Board.

State Sen. Larry Stutts (R-Tuscumbia) said in an interview recently, "[H]ealth care is a little bit unique in that it's not totally a free market because insurance companies control a lot of reimbursement."

"Medicaid is a big controller of what reimbursement is. The fact is if you can offer a service, I don't think you ought to have to seek state approval to offer that service," he added.

Stutts told 1819 News that "every hospital in the state spends a boatload on attorneys either for or against Certificate of Need applications."

"That's a waste of health care resources," Stutts said. "There's only so much money in health care. That money is generated by taking care of patients. When you spend a significant portion of that, jumping through the hoops of the Certificate of Need process it's resources that could be spent in other places more effectively. The process is not open and above board. We've had people in the state go to prison because of CON issues. It's not a fair process."

According to Stutts, a survey done by the member physicians of the Medical Association of the State of Alabama showed support in the state for ending CON.

"We did do a survey several years ago however the results of that survey was for our internal use and not intended for publication. In addition, due to the fact that the survey was done 4 or 5 years ago, I believe the information would be out of date and therefore of limited value," Mark Jackson, executive director of the Medical Association of the State of Alabama, told 1819 News recently.

Stutts said he thinks most of the medical community agrees with his stance on the need for reforming the CON process in Alabama.

"Not the medical community as in the Alabama Hospital Association but among physicians," Stutts said. "There are some states that just don't have it. We have one of the most restrictive ones in the country. It's just an expensive proposition to work through the process and it takes years. The people that are opposed to reforming the CON law are the ones that already have one. All it's doing is squelching competition."

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